What does it mean? Anti-TPO in results.

[djdd87]

Hi all,

I had Papillary Thyroid cancer in 2014 at the age of 26. They removed the right lobe first as the FNA was inconclusive, but then performed a total thyroidectomy following confirmation of the cancer. The cancer was encapsulated, so the risk of it spreading was low apparently.

Regardless I underwent a low dose treatment of RAI and my post operative CT scan showed a small remnant of Thyroid tissue in the right side of my neck.

A few weeks ago I got a letter out of the blue requesting a CT scan, which I duly attended and the nurse doing the scan said there was no thyroid remaining and nothing obvious there that should be there (yay).

Then yesterday I received a letter forwarded from my GP by an ENT consultant saying that I'd missed an appointment (I hadn't, I'd rearranged it for the start of August) and that they had arranged an Ultrasound because I registered Anti-TPO in my bloods in April 2016! (2 years ago.)

My Tg levels have been undetectable since 2014, which I'm led to believe is as very good thing as it means there's no thyroid tissue (good or cancerous).

The consultants other comment was that I'm still Tsh suppressed, which goes against the modern recommendations considering my risk factor, aside from the fact I have Anti-TPOs in my blood.

I take 200mg of levothyroxine a day, which I've been told by nurses is not sustainable for a lifetime.

Can someone please clarify why the consultant is concerned about Anti-TPOs (which I believe are antibodies that kill off thyroid cells anyway?), and what the issue with being Tsh suppressed is?

I'm a fit 30 year old male taking 200mg of levothyroxine each day. I feel perfectly well in myself and don't suffer with excessive weight loss or gain and sleep fine.

[Angel_of_the_North]

Don't know what Anti-TPOs are but TPO antibodies show that someone has autoimmune thyroid disease (hashimotos), but since you don't have a thyroid that is really irrelevant. You need TSH suppressed if you've had thyroid cancer and 200mcg levo isn't a high dose. There is no real issue with TSH being suppressed. If it is suppressed naturally because free t3 and free T4 are way over range (as in Graves disease), the high thyroid hormones (not low TSH) can cause heart problems and osteoporosis, but if your thyroid hormones are in range that's not an issue - better a suppressed TSH than more cancer. I would try to find an endo with a clue.